Individual
JANA RAQUEL MULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
43-2026 PAAUILO MAUKA RD, PAAUILO, HI 96776
(808) 776-1704
Mailing address
PO BOX 485, PAAUILO, HI 96776-0485
(808) 776-1704
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD60665668
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043291115
—
WA
01
—
P01702028
RR PTAN WVH
WA
Enumeration date
11/07/2005
Last updated
02/28/2023
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